Herpes Simplex Encephalitis – Board-Style Questions

What this deck covers

herpes simplex encephalitis in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. When to suspect it
2. Which virus
3. The spinal fluid
4. An added drug
5. The brain images
6. The brain wave trace
7. Why it is safe
8. How much to give
9. A rising creatinine
10. Late to hospital
11. Stopping early
12. Worse again
13. Not responding
14. Twice in one family
15. Strange spells
16. What matters most
17. Coming back again
18. Back to school

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: A single short generalised seizure with a fever, Type 1, travelling along the olfactory or trigeminal nerves, Many neutrophils with a very low glucose ratio, Decline, since steroids stop aciclovir entering the brain, Swollen, bright medial temporal lobe and insula, one side more, Generalised three-per-second spike and slow wave discharges, It is made active in the liver before it ever reaches the brain, 20 mg per kilogram as a single dose, repeated if needed, Drug crystals deposited within the renal tubules, A repeat PCR on a throat swab taken from the tonsils, Only after the full course, whatever the results, A second herpes infection acquired in hospital, Foscarnet, which inhibits the viral polymerase directly, A deficiency of the terminal complement components.

Clinical pearls from this deck

• Odd behaviour over 24 hours with fever: think encephalitis.
• Herpes encephalitis in a child: type 1, along the nerves.
• Herpes encephalitis fluid: lymphocytes and red cells.
• Herpes encephalitis: no routine steroids.
• Herpes encephalitis on imaging: medial temporal and insula.
• Herpes encephalitis on EEG: periodic temporal discharges.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Infectious Disease case decks · pediatric reference values.